Medical Students Report Critical Attitudes About Depression Among Their Peers

Medical students experience depression at a higher rate than the general population and attach high levels of stigma to the mental illness, according to University of Michigan Health System research to be published Sept. 15 in the Journal of the American Medical Association. Included in this report is a video interview with Thomas L. Schwenk, M.D., the lead author on the paper and the George A. Dean, M.D. Chair of U-M’s Department of Family Medicine.

The study showed that 53.3 percent of medical students who reported high levels of depressive symptoms were worried that revealing their illness would be risky. Almost 62 percent of the same students said asking for help would mean the student’s coping skills were inadequate.

Those with moderate to severe depression also agreed that revealing depression would mean others would find them unable to handle medical school responsibilities and that fellow students would respect them less.

The study showed 14.3 percent of the students reported moderate to severe depression, which is higher than the 10 to 12 percent usually found in the general population, says Thomas L. Schwenk, M.D.

“These results show that students who are depressed feel highly stigmatized by their fellow students and faculty members,” says Schwenk, who also is a professor of Family Medicine.

“Medical students are under extraordinary demands. They feel they are making life and death decisions and that they can never be wrong. There is such tremendous pressure to be perfect that any sense of falling short makes them very anxious.”

What’s worrisome about these results is they may indicate students will be less likely to get treated if they are suffering from depression, Schwenk says. Across the board, the results showed that medical students viewed depressed students as less valuable, Schwenk adds.

“There seems to be a significant level of intolerance of depression and by inference, mental illness in general. Students may be inappropriately equating depression with performance problems,” Schwenk says.

“We want to provide a medical education environment in which depression is treated like any other medical problem, worthy of treatment, detection and prevention. Most importantly, we want the medical students to be comfortable seeking help.”

From the public’s perspective, the results are disturbing because they may indicate intolerance toward patients with depressive symptoms.

“If medical students are critical of each other about depression, how does that transfer to patients? We don’t want the medical education experience to make them less tolerant of mental illness. Stigma seems to be lessening among the general public. But it is possible the medical professional is lagging behind,” Schwenk says.

“Somehow we have to change the environment in which we are teaching future physicians.”

Schwenk says that at U-M and many other medical schools, students have access to confidential treatment and services related to depression. Students need to be encouraged to take advantage of those resources.

Schwenk says he plans to continue the research by continuing to follow the students studied as they progress through their training. This study involved students enrolled at the University of Michigan Medical School in September to November 2009.